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In 2014, the International Diabetes Federation Life for a Child (LFAC) Programmes’s largest donor – The Leona M and Harry B Helmsley Charitable Trust – commissioned the London School of Hygiene and Tropical Medicine to conduct a comprehensive formal evaluation of the work of LFAC.
The work was conducted by a team lead by Professor Martin McKee and Dr. Sue Atkinson. Site visits were done in five countries: Rwanda, India, Jamaica, Mexico, and Philippines.

From the Executive Summary (2015):

“The review covered five themes:
• IDF-LFAC structure and organization
• Optimal strategic framework for high impact sustainable results
• Changes to polices that could improve quality, quantity, efficiency and effectiveness
• Impacts on countries, systems and children
• Impact on long term sustainability in T1D care delivery systems

The review overall shows that LFAC is a strong programme that is delivered well and is highly valued by the countries and the children, young people and their families that are supported by it. It is clear that LFAC enables children and young people with type 1 diabetes to survive and, as the programme and country policies strengthen, enables them also to thrive.

LFAC already does many things right and the team, albeit small, are extremely dedicated and enthusiastic. Many aspects are to be applauded and continued.

The review identifies LFAC’s strengths and challenges. It focuses particularly on the Programme’s engagement in-country and on how LFAC develops a strategic direction for care and treatment of type 1 diabetes. It identifies a need for developing country leadership and building local capacity, implementing approaches that catalyze systemic improvements in type 1 diabetes care delivery systems.

The ultimate goal must be for people with type 1 diabetes to be able to get good treatment and care within their country’s health system. Unfortunately, this does not appear to be a realistic goal in the short term in most countries. Nevertheless, there is a need for a higher priority to be given to the medium and long-term sustainability of the support provided for children with type 1 diabetes, making full use of the experiences gathered by LFAC and the information that it has collected on burden of disease, health needs, and barriers to be overcome in obtaining effective care by people with type 1 diabetes.

The five themes are explored in depth and recommendations made in relation to each”.

Work is now underway to strengthen sustainability aspects and implement the other recommendations of the report.

Ogle GD, Middlehurst AC, Silink M. Estimate of numbers of children and youth <26 years of age in lower-income countries who need help to receive standard diabetes care. International
Society for Pediatric and Adolescent Diabetes Annual Conference, Montreal, Oct 2014 Email LFAC for copy.

Orchard TJ, Sibomana L, Miller R & on behalf of the Association Rwandaise des Diabetiques, the National University of Rwanda, the University of Pittsburgh, and the Life for a Child Programme. Evaluation of differing type 1 treatment regimens in Rwanda. International Society for Pediatric and Adolescent Diabetes, Toronto, 2014. Email LFAC for copy.